Pain in the prostate can have many different causes, which do not always have to be in the prostate itself. On the one hand, benign enlargement of the prostate, which occurs in most men over the course of their lives, can cause pain in the prostate, due to the mere expansion or partial dislocation of the urethra and the resulting backlog of urine. However, acute or chronic inflammation of the prostate (prostatitis) as well as a tumor or prostate stones can also be a possible cause.
In addition, treatment performed in the region of the pelvis, whether by surgery or radiation, can be accompanied by hardening and adhesions in the pelvic floor or the prostate itself. These then cause pain and tension by disturbing the natural structure. In the worst case, the pain of the prostate occurs in the form of the so-called pelvic pain syndrome. The pain extends to the entire pelvic floor, is chronic and difficult to treat. We examine the prostate, for example, with the MRI.
Pain Character
Pain of the prostate is usually not limited to the organ itself. Because of its anatomical position, the prostate has close contact with the urethra, genitals and pelvic floor, these areas are usually affected by a painful process in the prostate area. Initially, pain in the prostate gland itself, as well as at the root of the penis and in the anal region, is typical.
However, these can also radiate into the testicles or lead to a painful sensation in the entire pelvic floor or lower abdomen. The intensity of the pain can depend strongly on the so-called vegetative sensation, i.e. also on the stress level, general well-being or digestion. The pain is usually aggravated by mechanical stress, such as when riding a bicycle or sitting. However, pain during urination, sexual intercourse and especially during ejaculation also indicate a cause in the prostate.
Causes
Prostatitis, i.e. inflammation of the prostate gland, in the narrower sense of the word, is an infection and inflammation of the prostate gland caused by microorganisms. This acute inflammation of the prostate gland by bacteria, however, accounts for only about 10% of inflammations of the prostate. Pathogens, especially in cases of general weakness of the immune system, manage to settle in the area of the prostate starting from the urethra.
This infection in turn leads to increased blood circulation and swelling of the prostate, causing pain, especially when sitting and urinating. If prostatitis is diagnosed too late, it can lead to severe general symptoms such as fever, chills and a strong feeling of illness. The bacterial infections of the prostate are often protracted, even with targeted treatment with antibiotics.
In addition to antibiotics, one should drink a lot and avoid sexual intercourse during the time of the acute infection. You can find more information on this topic at Inflammation of the prostate A very common cause of pain in the prostate is, as mentioned above, chronic prostatitis, i.e. a longer-lasting inflammation of the prostate. In contrast to acute prostatitis, this is usually not caused by bacteria.
Only rarely is a poorly healed bacterial prostatitis the cause. The non-bacterial, chronic form is also known as chronic pelvic pain syndrome. This name already makes it clear that the pain is not limited to the prostate gland itself.
In most cases it radiates to the entire perineal and anal region. The exact causes are not conclusively known, but are probably due to a vegetative dysfunction. They can originate from the prostate gland itself or from the surrounding tissue, whereby the two causes can ultimately be mutually dependent and reinforce each other.
For example, both irritation of the prostate can lead to cramping of the pelvic floor with venous congestion of the surrounding blood vessels and nerve irritation, and a tense pelvic floor can cause irritation of the prostate. This can occur especially after previous operations in the pelvic area or as a result of therapeutic radiation. Prostate stones or chronic irritation of the surrounding nerves can also be responsible, as can cysts or adhesions.
The pelvic pain syndrome represents an exclusionary diagnosis.This means that one can only speak of a pelvic pain syndrome when an acute inflammation, tumors or other causes have been ruled out by the doctor. Prostatodynia is an irritation of the prostate gland that is not caused by bacterial pathogens. In contrast to pelvic pain syndrome, however, it is limited to the prostate gland itself.
It can be caused by mechanical stimuli, e.g. during long bicycle rides, horse riding, cold and wet stimuli (e.g. a wet bathing suit) or by long periods of sexual inactivity. An increased stress level can also have a direct effect on the prostate and trigger tension and pain.
In most cases, pain in the area of the urethra or testicles occurs in addition to the pain of the prostate. Sitting for long periods or poor eating habits that lead to constipation can also cause pain. Benign prostatic hyperplasia is a benign enlargement of the prostate gland that affects more than 2/3 of men over 70.
The tissue of the prostate increases and presses on the urethra, among other things. Due to the limited space in the pelvis and the proximity of the urethra and pelvic floor, the enlargement also causes pain, including pain in the prostate itself. In most cases, however, the other symptoms are in the foreground, especially at the beginning, such as the obstruction of the flow in the area of the urethra, which causes problems when urinating.
Depending on the degree of enlargement, prostate hyperplasia can be treated with medication or surgery. A tumor of the prostate, especially prostate cancer, can also cause pain in the prostate. Prostate carcinoma is the most common type of cancer in men in Germany and also a very common cause of death.
However, early detection of the tumor, especially through regular screening examinations, can significantly improve the success of therapy. The pain of the prostate occurs in prostate cancer only at a late stage. They are often difficult to distinguish from the symptoms of benign enlargement of the prostate.
The pain itself can be caused by both the growth of the tumor and an accompanying inflammation. They are often accompanied by blood admixtures in the urine or seminal fluid. Otherwise, the symptoms are similar to those of benign prostatic hyperplasia.
Prostate cancer is one of the tumor diseases that become symptomatic only at a late stage and even then cause rather unspecific symptoms. Pain in the prostate can be a symptom and should therefore be clarified by a doctor. However, other diseases such as inflammation of the prostate, the so-called prostateitis, are also possible and often even more likely.
They are the most common cause of prostate problems. A benign increase in the size of the prostate gland, the prostate adenoma, is also a common cause of pain or sensation and should also be considered as a possible cause. In cancer, pain is often not limited to the prostate, but also affects neighboring organs such as the rectum due to the growth of the tumor into the surrounding tissue.
As a result, pain in the perineal area and pain during bowel movements can occur. Pain in the prostate is therefore more likely to occur in conjunction with other symptoms and less often alone. Other symptoms of prostate cancer, which often appear much earlier than the pain, can include burning sensation or problems urinating.
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